Journal of cardiovascular electrophysiology
-
J. Cardiovasc. Electrophysiol. · Dec 2011
Deep sedation for catheter ablation of atrial fibrillation: a prospective study in 650 consecutive patients.
Catheter ablation of atrial fibrillation (AF) is a highly invasive and relatively long-lasting procedure with specific requirements for patient sedation. The feasibility and safety of deep sedation is described in a prospective study of 650 consecutive patients. ⋯ Deep sedation for catheter ablation of AF is feasible and safe. Especially, the goal of keeping the patient in deep sedation while maintaining spontaneous ventilation and cardiovascular hemodynamic stability was accomplished. Endotracheal intubation or consultation of an anesthesiologist was not necessary in any patient.
-
J. Cardiovasc. Electrophysiol. · Nov 2011
Randomized Controlled Trial Comparative StudyIdentifying the relationship between the non-PV triggers and the critical CFAE sites post-PVAI to curtail the extent of atrial ablation in longstanding persistent AF.
Complex fractionated atrial electrograms (CFAE) ablation has been performed in addition to pulmonary veins (PV) isolation to increase the success rate of atrial fibrillation (AF) ablation in patients with longstanding (LS) persistent AF. The mechanism underlying the clinical benefit of CFAE ablation remains, however, poorly understood. ⋯ Non-PV triggers inducing AF post-PVAI were associated with the presence of stable or transient CFAE in 48% and 28% of cases, respectively, in LS persistent AF. CFAE ablation after PVAI was associated with a significantly higher elimination of those non-PV triggers. This suggests that at least part of the beneficial effect achieved by CFAE ablation reflects elimination of non-PV AF triggers.
-
J. Cardiovasc. Electrophysiol. · Nov 2011
Characteristics and significance of very early recurrence of atrial fibrillation after catheter ablation.
Early restoration of sinus rhythm following ablation of atrial fibrillation (AF) facilitates reverse atrial remodeling and improves the long-term outcome. The purpose of this study was to determine the predictors and outcome in patients with very early AF recurrences (< 2 days). ⋯ Very early recurrence occurred in patients with paroxysmal AF is not associated with long-term recurrence. Nonparoxysmal AF is an independent predictor of late recurrence of AF in patients with very early recurrence.
-
J. Cardiovasc. Electrophysiol. · Oct 2011
ReviewNon-surgical left atrial appendage closure for stroke prevention in atrial fibrillation.
Non-Surgical Left Atrial Appendage Closure for Stroke Prevention in Atrial Fibrillation. The most feared complication associated with atrial fibrillation (AF) is stroke, the risk of which increases with advanced age. Because of its complex anatomy and diminished blood flow during AF, the left atrial appendage (LAA) has been a common site of left atrial thrombi and presumed source of thromboembolism. ⋯ The nonsurgical approaches to excluding the LAA from the central circulation can be divided into 3 broad categories: transseptally placed devices, percutaneous epicardial approach, and hybrid approaches. The availability of several approaches will allow physician selection of the optimal approach for a given patient based on clinical, physiological, and anatomical considerations. LAA exclusion stands to become an increasingly attractive option for patients with nonvalvular AF because it can be offered to elderly AF patients, and eliminates the long-term cumulative bleeding risks and adherence challenge of anticoagulants.